Welcome to AMS Blog

Saturday, January 07, 2012

January 4, 2012, 5:22 p.m.
Reporting from Sacramento— Fewer California companies offered their workers health insurance last year, and the ones that did charged employees more for their coverage.

That's among the findings of an annual California Employer Health Benefits Survey released Wednesday by the California HealthCare Foundation, a research and grant-making nonprofit organization.

According to the survey, premiums for employer health insurance plans have risen 153.5% since 2002, a rate that's more than five times the increase in California's inflation rate.

In the last two years alone, the proportion of state employers offering coverage to workers fell to 63% from 73%, the survey said.

"This is a departure from previous years and could be an early sign of future changes," the foundation report noted in commentary on data collected between July and October 2011 in interviews with 770 private firm benefit managers.

The steady rise in costs during a prolonged economic downturn contributed to decisions by about a quarter of employers to either reduce benefits or increase cost sharing for employees in 2011. A slightly smaller percentage, 22%, opted to make workers pay more of the share of the higher premiums.

Health insurance is expected to take even more money out of workers' pockets this year. The survey indicated that 36% of California firms said they were either "very" or somewhat" likely to raise the amount that their staff paid in premiums in 2012.

Rising costs and shrinking coverage are accelerating, said Anthony Wright, executive director of Health Access California, a group that advocates for expanded health insurance coverage.

"They are frankly multi-decade trends," he said. "What is notable is that this is more significant than usual."

What's been a "gradual erosion of employer-based coverage in good years" has evolved into "a steep one in bad years," Wright said. "To be down to 63% [of California companies offering coverage] is huge. It used to be up over 80%."

Patrick Johnston, president of the California Assn. of Health Plans, blamed the rising premiums on expensive technology, the spread of chronic disease and an aging population, among other factors. Johnston's organization represents 40 California health plans that cover 21 million people.

What's more, he noted that years of cutting reimbursements to doctors and hospitals by the government-run Medi-Cal program have created a "cost shift" that has to be "made up in negotiations for higher rates for commercial payers such as employers."

Insurer profits, Johnston argued, are not a leading cost driver since publicly traded California insurers keep only 13 cents out of every premium dollar to pay for expenses and to secure earnings that average 3% to 5% of revenue.

Both Wright and Johnston predicted that full implementation of President Obama's healthcare reform plan in 2014 could go a long way toward broadening coverage and to an eventual control of raging medical cost inflation.

"I hope that some of the reforms start to change the picture," Wright said. "It's clear that if we repeal [the law] or retreat back to the status quo, we will have some trends that simply are unsustainable."